Dysuria

DESCRIPTION

Symptoms of pain and/or burning on urination

ETIOLOGY

• Infectious
  • Cystitis
    • Bacterial
    • Viral (i.e., adenovirus)
    • Interstitial
  • Pyelonephritis
  • Urethritis
    • Viral infection
    • Herpes simplex
    • Neisseria gonorrhoeae
    • Chlamydia trachomatis
  • Balanitis/balanoposthitis
  • Vaginitis
    • Candida albicans
    • Group A Streptococcus
    • Shigella species
  • Cervicitis
  • Pelvic inflammatory disease (PID)
  • Varicella
  • Tuberculosis
  • Pinworms
    • Pruritus rather than true dysuria
• Congenital/anatomic
  • Urethral stricture
  • Meatal stenosis
  • Labial adhesions
  • Lichen sclerosis
  • Vesicovaginal fistula
  • Virginal vaginal ulcers
• Trauma
  • Masturbation
  • Sexual abuse
  • Foreign body
  • Diaper dermatitis
  • Bicycle injury
  • Irritation
• Toxic/environmental/drugs
  • Bubble baths
  • Detergents
  • Fabric softeners
  • Perfumed soaps
  • Spermicides/douches
  • Cyclophosphamide
• Urolithiasis or hypercalciuria
• Systemic illnesses
  • Stevens-Johnson syndrome
  • Behçet syndrome
  • Reactive arthritis
  • Food allergy
  • Contact dermatitis
• Functional
  • Dysfunctional voiding
  • Interstitial cystitis/bladder pain syndrome
• Tumor
  • Sarcoma botryoides

PATHOPHYSIOLOGY

• Muscular contraction of the bladder and peristaltic activity of the urethra
  • Stimulates pain fibers in inflamed mucosa
• Pain when urine contacts inflamed mucosa

COMMONLY ASSOCIATED CONDITIONS

• Congenital anomalies of the kidney and urinary tract (CAKUT)
• Kidney stones